Ureteroenteric fistula shown only on bone imaging.
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Aged↗
Biomedical subjects
K Uno
Publications and source records attributed to K Uno.
[Evaluation of clinical utility of 111In-DTPA-IgG scintigraphy in the detection of inflammation/infection--a report of multicenter phase III clinical trials].
This is the report of phase III study to evaluate the safety and utility of 111In-DTPA-IgG in patients with strongly suspected inflammation/infection. One hundred and forty five patients with suspected sites of inflammation/infection were enrolled in the study. Only a few adverse experiences in one patient were reported, which were interpreted as having a possible relationship to the agent. A total of 171 suspected sites (12 in head and neck, 39 in thorax, 44 in abdomen and pelvis, 62 in musculoskeletal system, and 14 in other regions) were evaluated by investigators at each institute. Out of 171 sites, 18 were determined to be unevaluable, and 12 false negative and 5 false positive cases were observed. Overall sensitivity and specificity was 89.8% and 85.7%, respectively, and the agent proved to be effective in detecting lesions anywhere throughout the body. The analysis of data from this Phase III study indicates that 111In-DTPA-IgG is well-tolerated in patients and effective in determining focal sites of inflammation/infection although the physiological accumulation in some tissues such as the sinus or liver and possible excretion into the gastrointestinal tract may make it difficult to localize lesions.
Aged↗
Expression of cathepsin E in pancreas: a possible tumor marker for pancreas, a preliminary report.
Ductal cancers of the pancreas frequently express markers of gastrointestinal epithelial cells. Cathepsin E (CTSE) is a non-secretory, intracellular, but non-lysosomal proteinase found in the highest concentration in the superficial epithelial cells of the stomach. The aims of our study were to examine the expression of CTSE in the pancreas, to establish an assay system of CTSE and to evaluate the diagnostic usefulness of CTSE in the pancreatic juice. Eleven patients with pancreatic ductal adenocarcinoma, 10 with mucin-producing adenoma, 3 with intraductal papillary hyperplasia and 43 with chronic pancreatitis were examined. Surgically resected pancreatic tissues were subjected to immunohistochemistry for CTSE. Pancreatic juice was collected from the patients and subjected to sandwich ELISA and Western analysis for detecting CTSE. Positive staining for CTSE was observed in pancreatic ductal adenocarcinoma by immunohistochemistry. CTSE was also expressed in mucin-producing adenoma, intraductal papillary hyperplasia and mucinous hyperplasia. CTSE in the pancreatic juice was present in 8 of 11 patients with pancreatic ductal adenocarcinoma, 5 of 10 patients with mucin-producing tumor, 1 of 3 patients with intraductal papillary hyperplasia and 4 of 43 patients with chronic pancreatitis. The detection frequency of CTSE in the pancreatic juice was significantly higher in the patients with pancreatic ductal adenocarcinoma than in the patients with chronic pancreatitis. Our findings suggest that the expression of CTSE is associated with the pathogenesis of pancreatic ductal adenocarcinoma, that CTSE in the pancreatic juice seems to be a useful marker for a definitive diagnosis and that CTSE may be expressed at a relatively early stage of multistep carcinogenesis in pancreatic lesions.
Adult↗
Occipitoatlantal and occipitoaxial hypermobility in Down syndrome.
STUDY DESIGN: In this study, the authors evaluated upper cervical spine in 75 children and adolescents with Down syndrome on the basis of lateral flexion-extension radiographs. OBJECTIVE: To assess occipitoatlantal motion and occipitoaxial motion in children and adolescents with Down syndrome compared with age-matched control subjects. SUMMARY OF BACKGROUND DATA: Although previous studies have described a high prevalence of occipitoatlantal hypermobility in Down syndrome, there have been no comparisons with age-matched control subjects. Only a few reports have mentioned the physiologic relation between the occiput and axis other than basilar impression. Moreover, there have been no reports examining anteroposterior mobility in abnormal conditions. METHODS: Seventy-five children and adolescents with Down syndrome and 30 age-matched control subjects were examined. Lateral radiographs of the upper cervical spine in flexion and extension were taken, and anteroposterior translation of the occiput in relation to the atlas and axis was measured. RESULTS: Anteroposterior occipitoatlantal hypermobility was found to be present in children and adolescents with Down syndrome even when compared with age-matched control subjects. Occipitoaxial hypermobility was observed only when atlantoaxial instability was present. CONCLUSION: In evaluating the upper cervical spine in Down syndrome, it is necessary to pay attention to the relation between the occiput, atlas, and axis.
Adolescent↗
Liver targeting of interferon through pullulan conjugation.
PURPOSE: The purpose of this study was to actively target interferon (IFN) to the liver through its chemical conjugation with pullulan, a water-soluble polysaccharide with a high affinity for the liver. METHODS: Chemical conjugation of IFN with pullulan was achieved by a cyanuric chloride method. Following intravenous injection of the conjugates to mice, their body distribution and the activity of an IFN-induced enzyme, 2', 5'-oligoadenylate (2-5A) synthetase in the liver and other organs, were evaluated. RESULTS: The cyanuric chloride method enabled us to prepare an IFN-pullulan conjugate that retained approximately 7-9% of the biological activity of IFN. Pullulan conjugation enhanced the liver accumulation of IFN and the retention period with the results being reproducible. When injected intravenously to mice, the IFN-pullulan conjugate enhanced the activity of 2-5A synthetase in the liver. The activity could be induced at IFN doses much lower than those of free IFN injection. In addition, the liver 2-5A synthetase induced by conjugate injection was retained for 3 days, whereas it was lost within the first day for the free IFN-injected mice. CONCLUSIONS: IFN-pullulan conjugation was promising for IFN targeting to the liver with efficient exertion of its antiviral activity therein.
2',5'-Oligoadenylate Synthetase↗
Effect of the oral administration of Lactobacillus brevis subsp. coagulans on interferon-alpha producing capacity in humans.
OBJECTIVE: This study was designed to determine whether the oral administration of Lactobacillus brevis subsp. coagulans modulates immunological responses in human subjects, and whether there are differences in response between live and heat-treated preparations. METHODS: The effect of the oral administration of Lactobacillus brevis subsp. coagulans (Labre) for 4 weeks on the interferon-alpha (IFN-alpha) producing capacity of apparently healthy subjects was evaluated. Sixty volunteers were divided into five groups for the determination of virus-induced IFN-alpha production in response to various doses of live and to heat-killed Labre. 2-5A synthetase activity was measured to detect trace amounts of IFN production. Routine blood tests were also performed to determine the state of health of the subjects involved in this study and to test any side effects of Labre treatment. RESULTS: The oral administration of live Labre showed a statistically significant increase in IFN-alpha production at 2 weeks (p < 0.05) and at 4 weeks (p < 0.05) in the group receiving 600 million bacteria/day and at 4 weeks (p < 0.05) in the group receiving 300 million bacteria/day. In particular, IFN-alpha production in those with initially low levels rose significantly when either 300 million or 600 million bacteria/day were ingested. Consumption of heat-killed Labre 300 million bacteria/day did not result in a statistically significant change in IFN-alpha production. The level of 2-5A synthetase activity remained the same in the control and experimental groups. CONCLUSIONS: Oral administration of live Labre significantly increased IFN-alpha production in a dose-dependent manner. Labre intake tended to be most beneficial in subjects with initially low levels of IFN-alpha production. Heat-treated Labre did not elicit a response similar to that of the live bacteria.
2',5'-Oligoadenylate Synthetase↗
Determination of interferon-alpha-producing capacity in whole blood cultures from patients with various diseases and from healthy persons.
To assess the clinical value of determination of the interferon (IFN)-producing capacity of patients, IFN production induced by Sendai virus (HVJ) in vitro was measured in cell cultures of whole blood from patients with various diseases. IFN production in patients with lung cancer, myelodysplastic syndromes, noninsulin-dependent diabetes mellitus, pulmonary tuberculosis, and asymptomatic HIV-1 infection was lower than that in healthy persons. Furthermore, periodic measurements of IFN production revealed decreasing IFN producing capacities in patients with lung cancer with progression of the tumor stage. However, increased IFN-producing capacities were observed in patients with tuberculosis after standard therapy. Further experiments showed that the main type of IFN induced in whole blood cultures was IFN-alpha, and decreased IFN production in patients did not result from a decreased number of leukocytes but rather from an impairment of cellular IFN production. The evaluation of IFN production in whole blood cell cultures may be a feasible method of assessing the impaired immune status.
Adult↗
A new device for the treatment of coloproctostomic stricture after double stapling anastomoses.
OBJECTIVE: A new device of staple cutter was developed to evaluate the clinical effect for the treatment of rectal stricture after the double stapling anastomosis. SUMMARY BACKGROUND DATA: The double stapling technique has become an established reconstruction method for patients with low anterior resection. The major complication of anastomotic stricture associated with circular stapling has been reported to be harmful and distressing. Because underlying mechanisms of stricture are not well understood, no prophylactic means have been developed and this results in postoperative dilation still being the only treatment available. Although various dilation methods are used for the treatment of stricture, none is fully satisfactory. METHODS: Low anterior resection was performed in 30 patients with rectal carcinoma using a double stapling technique. First, the incidence of the anastomotic stricture and the clinical factors that contribute to the stricture formation were studied. Second, the clinical effects and advantages of the treatment of coloproctostomic stricture using the newly developed device (staple cutter) were evaluated. RESULTS: Nine (30%) of 30 patients had anastomotic stricture with the symptom of distressing frequent bowel movement. There was no significant relation between the clinical factors and the stricture when compared with that of nonstricture patients. Excellent dilation was performed in all of the nine strictures using the staple cutter, and the symptom of stricture disappeared dramatically in eight patients (89%) within 1 week. The recurrence of stricture occurred in two patients; however, it has not been observed after one further use of this treatment. The staple cutter is safe and easy to use even at the bedside, and except for a conventional anoscope, no special equipment, including fluoroscope, was needed. CONCLUSIONS: From the significant effects and advantages, the procedure using staple cutter is recommended highly for the treatment of circular stapling anastomotic stricture of the rectum.
Adult↗
Recurrent hearing impairment and nystagmus induced by repeated antigen exposure in actively sensitized guinea pigs.
Although many studies have suggested a relation between allergy and Ménière's disease, the pathophysiology of this condition remains controversial. The aim of this study was to clarify whether an anaphylactic reaction in the inner ear can disturb hearing and equilibrium, and whether such disturbances recur in response to repeated anaphylactic reactions. Increases in audiological threshold, nystagmus, and endolymphatic hydrops were observed in response to a single exposure to antigen administered to actively sensitized guinea pigs. The increase in audiological threshold was maximal 10 h after antigen challenge (p < 0.005) and returned to the baseline level after 7 days. Nystagmus and the increase in audiological threshold induced by antigen exposure were inhibited by prior administration of pemirolast potassium (p < 0.05), an inhibitor of chemical mediator release from mast cells. A second challenge with antigen 7 days after the first also induced an increase in audiological threshold (p < 0.05) and nystagmus. These results suggest that studies of repeated antigen challenge in actively sensitized animal models may increase our understanding of the pathophysiology of Ménière's disease.
Anaphylaxis↗
Muscarinic acetylcholine receptors on human lymphocytes in patients with Menière's disease.
To investigate patients with Menière's disease and the association of cholinergic hyperreactivity, we performed muscarinic acetylcholine receptor assay using peripheral blood lymphocytes from patients with Menière's disease and non-dizzy, non-allergic control subjects. Cholinergic receptor maximal bindings (Bmax) and dissociation constants (Kd) were compared between the two groups, indicating the number and the affinities of the receptors, respectively. The receptor Bmax value in Meniére's patients during the remission state (108.6 +/- 51.2 fmol/l x 10(6) lymphocytes) was higher than that in normal controls (45.8 +/- 9.2 fmol/l x 10(6) lymphocytes) (p < 0.01). Furthermore, during an exacerbated state, Bmax was increased significantly (223.7 +/- 90.2 fmol/l x 10(6) lymphocytes) compared to the remission state (p < 0.01). In contrast, Kd values for the receptor did not differ between the two groups. These results suggest that patients with Menière's disease have cholinergic hyperreactivity, which may be further upregulated during a state of exacerbation due to an increase in the number of cholinergic receptors.
Adult↗
[111In-labeled leukocyte scintigraphy in patients with inflammation of unknown focus].
This study evaluates the usefulness of 111In-labeled leukocyte scintigraphy to localize inflammatory foci that cannot be determined by clinical symptoms and other imaging studies. Patients with persistent fever following abdominal surgery (n = 20), suspected post-traumatic osteomyelitis associated with multiple fractures (n = 5), and fever of unknown origin (n = 22) were recruited. In all patients, the exact location of inflammatory foci could not be determined by clinical symptoms and conventional imaging studies. In patients with post-surgical fever, leukocyte scintigraphy localized responsible foci in 65% of patients and provided clinically useful information for the treatment. In patients with multiple fractures, the location of osteomyelitis was diagnosed confidently in only one case (20%). In patients with fever of unknown origin, responsible foci were detected in 18% of patients. Although in those patients positive leukocyte studies provided clinically useful information, overall usefulness seemed to be limited. Leukocyte scintigraphy is able to detect inflammatory foci in patients with post-surgical fever, but less likely to localize responsible foci for post-traumatic osteomyelitis or fever of unknown origin when patients have been examined carefully by clinical symptoms and conventional imaging studies.
Abdominal Abscess↗
[Assessment of clinical utility of 111In-DTPA-IgG scintigraphy in the detection of inflammation/infection--a report of multicenter phase II clinical trials].
A Phase II clinical study was performed in patients with strongly suspected focal sites of inflammation/infection to investigate clinical utility of 111In-DTPA-IgG. Neither adverse effects nor abnormal laboratory changes were noted in the all cases. Out of 59 patients, the clinical utility was evaluated in 56 patients with a total of 67 suspicious sites (19 in thorax, 13 in abdomen and pelvis, 30 in musculoskeletal system, and 5 in other regions). True positive results were obtained in 100% of lesions in the thorax (13/13) and the musculoskeletal system (26/26). There were three false negative and five false positive results. Overall sensitivity and specificity was 94.0% and 70.6%, respectively. Most of the true positive scintigram with the best image quality was acquired at Day 1 or Day 2 post-injection. A dose of 80 MBq was considered to be a practical dose for imaging. Our study indicates that 111In-DTPA-IgG is a safe and promising imaging agent for the detection of inflammation/infection, and that it is reasonable to proceed with Phase III studies to further evaluate clinical utility of the agent.
Adult↗
[Development of intrahepatic cholelithiasis long after primary excision of choledochal cysts].
Biliary sricture with dilatation is a putative cause of intrahepatic bile duct stones. However, this hypothesis has never been proven. Fifty-six patients had operative cholangiography, underwent standard excision of a choledochal cyst, and were reviewed at follow-up clinics at a mean follow-up time of 14 years and 6 months. The incidence of complications such as intrahepatic cholelithiasis was analyzed according to the morphologic types of the intrahepatic bile ducts as observed at the initial operation. Group I patients (29 cases) did not show any dilatation of the intrahepatic bile ducts. Only one (3%) developed intrahepatic cholelithiasis. In Group II (24 cases), the intrahepatic bile ducts were dilated but not associated with any down-stream stenosis, one patient (4%) suffered from intrahepatic chalelithasis. Group III patients (3 cases) had dilatation of the intrahepatic bile ducts associated with a down-stream stenosis, and none of them was free from the development of intrahepatic biliary stones (3 cases). Group III patients are most likely to develop intrahepatic cholelithiasis afterwards, and their stenosis should be relieved by whatever means are feasible at initial operation.
Adolescent↗
[Diagnostic accuracy of 201T1 SPECT.MRI in brain diseases and inter-reader variance of diagnostic performance].
Fifteen-four studies of 201T1 brain tumor SPECT were independently interpreted by 9 nuclear medicine physicians with and without reference magnetic resonance images in 2 separate sessions to define an effect of referring images, and inter-observer variations. The physicians were requested to detect foci of abnormal deposits, and to discriminate whether they were malignant or not according to 5-grade scaling of subjective diagnostic confidence. Receiver-operating characteristics (ROC) analysis was performed. Mean sensitivity for presence of lesions (SEP), and sensitivity and specificity for malignancy of 201T1 SPECT were 84, and 53 and 55%, which were changed to 94, and 74 and 55% after referring to the MR images. The SFP was significantly improved (p < 0.05), but sensitivity and specificity for malignancy, assessed by areas under the ROC curves, were not significantly improved. Inter-observer variation of the SFP was significantly reduced with addition of the referring MR images. Cerebral lobar localization of lesions by SPECT showed great inter-observer variations (true localization ranged from 30 to 68.4%). It is concluded that 201T1 brain tumor SPECT has moderate sensitivity and specificity for malignancy, which is not improved by addition of anatomical reference images, that additional MR images reduce inter-observer variation of confidence on lesion presence, and that SPECT localization of lesions has great inter-observer variations.
Adolescent↗
Development of intrahepatic cholelithiasis long after primary excision of choledochal cysts.
BACKGROUND: Biliary stricture with dilatation is a putative cause of intrahepatic bile duct stones. However, this hypothesis has never been proved. STUDY DESIGN: Fifty-six patients had operative cholangiography, underwent standard excision of a choledochal cyst, and were reviewed at follow-up clinics at a mean follow-up time of 13 years and 6 months. The incidence of complications such as intrahepatic cholelithiasis was analyzed according to the morphologic types of the intrahepatic bile ducts as observed at the initial operation. RESULTS: Group 1 patients (29 cases) did not show any dilatation of the intrahepatic bile ducts. Intrahepatic cholelithiasis developed in only one case (3 percent). In group 2 (24 cases), the intrahepatic bile ducts were dilated but not associated with any downstream stenosis. One patient (4 percent) suffered from intrahepatic cholelithiasis. Group 3 patients (3 cases) had dilatation of the intrahepatic bile ducts associated with downstream stenosis, and none of them was free from the development of intrahepatic biliary stones (3 cases). CONCLUSIONS: Patients with biliary dilatation with stricture of the intrahepatic bile ducts are most likely to develop intrahepatic cholelithiasis after surgical excision of a choledochal cyst, and their stenosis should be relieved by whatever means feasible at initial operation.
Bile Ducts, Intrahepatic↗
[Tumor imaging in nuclear medicine].
Tumor imaging in nuclear medicine has been improved by imaging instruments and newly developed radiopharmaceuticals. One of the imaging developments is a SPECT system using three-detector system. Its each detector rotates 120 degrees when SPECT projection data are acquired and we can save the scanning time and get a high resolution image which is less than 10 mm FWHM. About radiopharmaceuticals 99mTc MDP and 57Ga-citrate are used most commonly for detecting early metastatic lesions in the body. 201Tl chloride and 99mTc MIBI as used for cardiac imaging are also used for tumor detection. 111In-DTPA-D-Phe-octreotide are developed for detection of somatostatin receptor and will be used for many kinds of tumor such as small cell lung cancer, meningioma, malignant lymphoma and gastrointestinal hormone producing tumor.
Citric Acid↗
A novel mutation substituting tryptophan with arginine in the carboxyl-terminal, non-collagenous domain of collagen X in a case of Schmid metaphyseal chondrodysplasia.
A novel nucleotide change in the collagen X gene was identified in a Japanese family with Schmid metaphyseal chondrodysplasia (SMCD). The T to C change at nucleotide 1951 resulted in replacement of tryptophan by arginine at residue 651 (W651R). This missense mutation is considered to be responsible for SMCD because 1, the same mutation was not be identified in the collagen X gene from normal individuals; 2, the mutation segregated with the SMCD phenotype in the index family; 3, the substituted amino acid is highly conserved in type X collagens, and 4, the mutation causes a marked change in the hydrophobicity profile of the surrounding region in the NC1 domain. This novel mutation (W651) seems to have the same impact on bone development as W651X mutation.
Amino Acid Sequence↗
Simultaneous determination of sulphamonomethoxine and its N4-acetyl metabolite in blood serum by high-performance liquid chromatography with direct injection.
A high-performance liquid chromatographic method with direct injection has been developed for the simultaneous determination of sulphamonomethoxine and its N4-acetyl metabolite in serum of animals and fish. A HISEP shielded hydrophobic-phase column (15 cm x 4.6 mm I.D.), a mobile phase of 0.05 M citric acid-0.2 M disodium hydrogenphosphate-acetonitrile (70:15:15, v/v), and ultraviolet detection at 265 nm were used. The standard calibration curves in serum of chicken, pig, cattle, rainbow trout and yellowtail were linear over the range 0.5-20 micrograms/ml. The recoveries of sulphamonomethoxine and its N4-acetyl metabolite from all serum samples determined at different concentrations (0.5, 2.0 and 10.0 micrograms/ml) were 93-103% and 90-103%, respectively. The lowest measurable sulphamonomethoxine and N4-acetyl metabolite concentrations were 0.04 and 0.1 microgram/ml, respectively, for all serum samples.
Acetylation↗